The Definitive Guide to Hair Loss for Women
Like many other women, I took my hair for granted. In the shower one morning I began to notice clumps of hair in my hand. I like to comb my hair in the shower and figured that the many strands of hair in my hand was the result of excessive pulling and combing.
My hair grows fast and thick anyways, so I didn’t think anything of it. Fast forward six months later and I should have thought something of it. The shedding and clumps of hair continued to show up in the shower and in my bed, until one day I noticed the front of my scalp looking peculiarly sparse and thin. A rush of anxiety burst through, I began to tremble. Upon closer examination it was clear what was happening – permanent and progressive hair loss.
Incorrect assumptions about who is likely to suffer from hair loss (mainly men I thought) and at what age this should occur (over 50 I thought) are all too widespread.
For women especially, their luscious locks are their most prized aesthetic feature, as hair means so much more to women than to men simply by virtue of nature and fashion. What most people don’t know, and what I had found through basic internet research, is that almost every woman develops some degree of hair thinning and as many as two-thirds suffer pattern baldness. Hair loss for women can start any time after the onset of puberty, but women tend to first notice it around menopause, when hair shedding typically increases. Women are also much more likely to damage and traumatize their hair due to brushing, styling, dyeing, coloring and heating. Over the course of a lifetime, women will have put their hair through incredible amounts of stress, styling and chemical wear and tear.
Recent research tells us that approximately twenty-five million women suffer from hair loss in the United States alone. The National Institute of Health reports: “Fewer than 45% of women go through life with a full head of hair. Female pattern hair loss is the commonest cause of hair loss in women and prevalence increases with advancing age.”
Hair loss in women can be devastating for their self-esteem and emotional well-being. The best reaction to sudden or gradual hair loss is not to panic or dive into drastic measures, but to start down the road of effective research and proactive inquiry. Ask yourself: have there been any recent changes to my lifestyle that may be having an adverse effect on my hair? Has my diet changed, or perhaps my physical fitness regimen? Diet and exercise are often correlated with hair loss and so careful monitoring of both are important.
Genetics and hormones are the other side of the female hair loss coin. “The physiology and epidemiology of female hair loss can look very different from male hair loss,” California-based hair transplant doctor Amir Yazdan tells groMD. “A woman can begin to lose hair because of a genetic predisposition or emergent thyroid complications – determining the root cause will give the patient an effective and actionable plan of attack. It could be something as innocuous as iron deficiency, or as critical as metabolic crisis.” The faster you detect their conditions, the better.
Happily, hair loss prevention and treatment options have greatly grown in popularity, safety, and effectiveness. Your hair loss is an important indicator of health and well being, so the journey towards hair restoration will be one of greater self-understanding and confidence.
What are the most common causes behind hair loss?
If you begin to find your scalp displaying less-than-usual thickness and follicular density, as I did, then it is time to see a board-certified dermatologist or hair restoration specialist. Amir recommends a formal evaluation to determine hair count, hair type and more, in order to gauge the nature and progression of the hair loss.
There are many causes behind hair loss in women – some of the most common include stress, unhealthy lifestyle choices and consistent usage of chemical sprays and gels. While the aforementioned causes can be found among men as well, certain female-only causes of hair loss may be associated with pregnancy, thyroid disorders and anemia.
The most common type of hair loss among women is pattern baldness, or androgenic alopecia. Pattern baldness is hereditary and occurs gradually as you age. According to the International Journal of Women's Dermatology a certain “genetic disposition permits normal levels of circulating androgen to act on follicular target cells, which are specially sensitized by binding to specific intracellular androgen receptors. In other cases, an androgen-independent mechanism may be involved…” This is simply to say that androgens play a crucial role in the pathogenesis of female pattern baldness.
Female pattern baldness has three main phases. The first is diffuse thinning on the crown and vertex areas of the scalp. The second phase is thinning of the bitemporal region with frontal gradations that extend outward across the scalp. The third phase is deep parting or recession in the biparietal and vertex regions. The illustrations below show clearly the increasing progression and manifestations of pattern baldness in women.
“If you begin to recognize the profile or silhouette of your hair and scalp resembling the illustrations above, do not rest content with internet solutions. Seek out a board-certified hair restoration specialist who can conduct a formal diagnosis of your scalp and administer blood tests. The results of an in-person expert consultation are a much more proactive and actionable plan to combat your hair loss,” Amir explains.
Shedding and Stress
Some women, believe it or not, experience periods of excessive hair shedding from intense emotional episodes or traumatic moments of stress. It may not necessarily stem from anything catastrophic either – starting a new multivitamin or thyroid medicine can cause metabolic and hormonal changes that prompt bouts of hair loss. The great bright side to this form of hair loss is that all the hair lost during periods of intense stress can come back. Dr. Yazdan explains that “women are especially at risk of telogen effluvium (stress-related hair loss) from high estrogen and cortisol levels, because of the hormonal imbalance that it creates, which in turn disrupts the smooth flow of the hair growth cycle.”
Breakage and Styling
Certain types of female hair loss can take the form of breakage as a result of damage being done to the protein structure of the hair follicle. Among African American women especially, where a culture of intense styling and braiding is prevalent, hair breakage and scarring on the frontal scalp region is very common.
Traumatized hair shafts, also called traction alopecia, is caused by the hair follicle and dermal papilla sustaining damage from constant long-term pulling and tension on the hair. Rather than being rooted in singular traumatic instances, then, it comes from light to moderate tension over years at a time. Those who usually wear their hair in braids or a bun, for instance, might find themselves suffering from this later in life if they don’t give their hair regular lengthy breaks.
If you wear your hair in a tight bun, braid, ponytail, weave or extension, for example, its important to forgo such styling habits every so often to avoid irreversible shaft damage.
If you notice random patches of thinning or balding on your scalp, then you likely are suffering from a condition called alopecia areata. Alopecia areata causes a unique form of hair loss different to the more common age-related male and female pattern hair loss and typically strikes before the age of 30. It’s also the most common autoimmune disease – when the body’s immune system attacks its own tissues, even more common than insulin-dependent diabetes, rheumatoid arthritis and thyroiditis. About 30% of individuals who develop alopecia areata find that their condition either becomes more extensive or becomes a continuous cycle of hair loss and regrowth. The most prominent symptom of alopecia areata is patchy hair loss. Coin-sized patches of hair begin to fall out, mainly from the scalp. Any site of hair growth may be affected including the beard and eyelashes.
This is a chronic condition and the sooner it is diagnosed, the sooner you can figure out the next steps.
Hair Loss Linked to Physical Health and Well Being
Female hair loss can either take the form of a diagnosable pathology or be the result of a larger underlying health issue. Hair follicles, just like skin, tissue, and other organs, are nourished by blood vessels that feed and create cells. As such, the health of a woman’s hair follicles are linked to the health and strength of her endocrine system. Iron and vitamin deficiencies can cause problems for the immune and endocrine systems, which may lead to hair thinning. “Severe and prolonged hypothyroidism and hyperthyroidism can cause loss of hair, [where] loss is diffuse and involves the entire scalp rather than discrete areas,” explains Endocrinologist Dr. Petros Perros.
Listen to what your body is trying to tell you if you are experiencing hair loss, because it may be a symptom of an issue unknown to you at the time and well worth investigating.
Proven Treatments and Solutions
Society and culture places a high burden on women’s appearance. It tells us that we should all aim to have a full head of luscious hair, but unfortunately this isn’t always a given. If you’ve begun to panic or stress out about quick fix solutions, don’t. We’ve got you covered with the best of the best – only the most proven and reputable hair restoration solutions.
The only FDA-approved female hair loss medication is minoxidil, and research has indicated that over 60% of women who use the medication consistently demonstrate a deceleration in hair loss and a re-growth of miniaturized follicles. Widely available in generic versions and under the brand name Rogaine, minoxidil has been documented to be more effective for women suffering from diffuse pattern baldness than it is for men.
A breakthrough in modern non-surgical hair restoration, Platelet Rich Plasma (PRP) therapy has been known to stimulate cell regrowth, decelerate hair loss, and aid in the hair restoration process. It involves drawing a small amount of blood from the patient’s body and processing it in a centrifuge in order to extract a rich plasma serum. This serum is then injected into the recipient site on the top of the scalp of the patient. Dr. Yazdan shares his clinical experience, explaining that “with the employment of PRP and added nutrients like Acell, I have seen accelerated healing, reduced swelling and stimulation of thinning hair. I like to use this in every hair restoration surgery because it often gives patients the absolute best results.”
The National Institutes of Health have described incredible preliminary results from PRP, reporting that a “significant reduction in hair loss was observed between first and fourth injection. Hair count increased from average number of 71 hair follicular units to 93 hair follicular units.”
Hair Restoration Shampoo & Conditioner
While the marketplace is saturated with hair growth supplements and hair care potions, quality hair restoration products that are engineered by board-certified hair restoration doctors are extremely rare, being the best in the industry. Research demonstrating the efficacy of most hair growth products reveal nothing short of empty promises and snake oils.
Doctor-designed for every hair type, groMD shampoo is equipped with Argan oil, Biotin, Niacinamide and other essential elements to protect and nourish for a healthy scalp.
Many powerful scalp, skin and hair nourishing ingredients go into groMD’s regrowth shampoo formula, but by far the most important is its DHT blocker. DHT is the essential hormone responsible for hair miniaturization and loss. You can also work the groMD follicle activator spray through the ends of your still damp hair to keep hair supple, nourished and shiny.
Hair transplantation is the most tried and true solution for permanently filling in areas of thinning hair or baldness on the scalp.
Surgical solutions for pattern baldness are typically classed under two types:
Follicular Unit Extraction (FUE)
Follicular Unit Transplantation (FUT/Strip)
FUE and Strip surgeries are minimally invasive outpatient procedures performed under local anesthesia. Hair transplant surgery uses a patient’s own natural DHT-resistant terminal hairs to restore the thinning or balding areas on the scalp. With the FUE procedure, hair follicles are removed one-by-one from the donor site. The hair follicles are then transplanted individually to the thinning or balding areas of the temple or crown. If done by a master hair restoration specialist, this method leaves no visible linear scar. With the FUT or strip method, a thin strip of scalp is removed from the back of the head containing numerous hair follicles. These follicles are then transplanted one-by-one into the balding area. This method leaves a very thin linear scar at the back of the head which is rendered non-visible once the hair grows back.
Being so busy with schooling and my career, I never really took hair health seriously, nor did I consider what underlying hormonal or autoimmune issues may be causing my increased thinning and shedding. There is a social stigma around female hair loss, and many women are embarrassed or anxious to talk about it with friends and loved ones. Our skin, scalp and tissue undergo great changes as we age and enter into motherhood, so there ought to be no shame in seeking medical intervention for hair restoration and hair health.